Is Chlorine The Right Decon Agent?

An article in the January 12, 2000 issue of the Journal of the American Medical Association (JAMA), suggests that emerging research and a lack of clear safety and efficacy data for bleach decontamination suggests that bleach should be avoided, especially if soap and water are immediately available. This article, written by Dr. Anthony G. Macintyre and others, assesses Health Care Facilities handling of contaminated casualties. The author suggests that adopting a universal decontamination process for all incidents might simplify this complex task and still be effective in decontamination of individuals.

Not only this article, but all civilian sources that I have read specify not to use bleach on skin. We have learned a great deal from all the anthrax hoaxes, and the omission of bleach is the biggest lesson learned. The CDC issued a statement with the same message last March.

If you think about it, it only makes sense. Bleach, even in 0.2% solutions, burns the skin. This,in turn, allows greater absorption of the toxin.

So, use it on whatever equipment you want, but keep it off your patients! MUMedic

This has been a fairly busy topic for the last few months in both military and civilian circles. The military has not changed their stance, but in our response world, it makes sense to use something that is cheap and, most importantly, comfortable for patients. A 0.5% bleach solution can cause significant skin irritation, and repeated exposures have been noted to cause a cumulative reaction to such exposures (one case notes a gentleman who cannot swim in pools anymore because of his sensitivity). Also, think about if there are traumatic injuries. The LAST thing I want is a bleach solution in a wound. Good way to wake a patient up though.
I have seen many solutions used, from a grease-cutting detergent mixed with water, to straight hydrant water, to sterile saline for open wounds. Keep the people who are going to be decontaminated in mind. Bleach will take a contact time of over 7 minutes to degrade any of the agents. No one will stand in your decon that long unless they are unconscious. Large amounts of water still is the most comfortable answer.